TY - JOUR
T1 - Brain Care Score and Neuroimaging Markers of Brain Health in Asymptomatic Middle-Age Persons
AU - Rivier, Cyprien A.
AU - Singh, Sanjula
AU - Senff, Jasper
AU - Tack, Reinier W.
AU - Marini, Sandro
AU - Clocchiatti-Tuozzo, Santiago
AU - Huo, Shufan
AU - Renedo, Daniela
AU - Papier, Keren
AU - Conroy, Megan
AU - Littlejohns, Thomas J.
AU - Chemali, Zeina
AU - Kourkoulis, Christina
AU - Payabvash, Seyedmehdi
AU - Newhouse, Amy
AU - Westover, M. Brandon
AU - Lazar, Ronald M.
AU - Pikula, Aleksandra
AU - Ibrahim, Sarah
AU - Howard, Virginia J.
AU - Howard, George
AU - Brouwers, H. Bart
AU - Van Duijn, Cornelia M.
AU - Fricchione, Gregory
AU - Tanzi, Rudolph E.
AU - Yechoor, Nirupama
AU - Sheth, Kevin N.
AU - Anderson, Christopher D.
AU - Rosand, Jonathan
AU - Falcone, Guido J.
N1 - Publisher Copyright:
© American Academy of Neurology.
PY - 2024/7/25
Y1 - 2024/7/25
N2 - Objectives: To investigate associations between health-related behaviors as measured using the Brain Care Score (BCS) and neuroimaging markers of white matter injury. Methods: This prospective cohort study in the UK Biobank assessed the BCS, a novel tool designed to empower patients to address 12 dementia and stroke risk factors. The BCS ranges from 0 to 21, with higher scores suggesting better brain care. Outcomes included white matter hyperintensities (WMH) volume, fractional anisotropy (FA), and mean diffusivity (MD) obtained during 2 imaging assessments, as well as their progression between assessments, using multivariable linear regression adjusted for age and sex. Results: We included 34,509 participants (average age 55 years, 53% female) with no stroke or dementia history. At first and repeat imaging assessments, every 5-point increase in baseline BCS was linked to significantly lower WMH volumes (25% 95% CI [23%-27%] first, 33% [27%-39%] repeat) and higher FA (18% [16%-20%] first, 22% [15%-28%] repeat), with a decrease in MD (9% [7%-11%] first, 10% [4%-16%] repeat). In addition, a higher baseline BCS was associated with a 10% [3%-17%] reduction in WMH progression and FA decline over time. Discussion: This study extends the impact of the BCS to neuroimaging markers of clinically silent cerebrovascular disease. Our results suggest that improving one's BCS could be a valuable intervention to prevent early brain health decline.
AB - Objectives: To investigate associations between health-related behaviors as measured using the Brain Care Score (BCS) and neuroimaging markers of white matter injury. Methods: This prospective cohort study in the UK Biobank assessed the BCS, a novel tool designed to empower patients to address 12 dementia and stroke risk factors. The BCS ranges from 0 to 21, with higher scores suggesting better brain care. Outcomes included white matter hyperintensities (WMH) volume, fractional anisotropy (FA), and mean diffusivity (MD) obtained during 2 imaging assessments, as well as their progression between assessments, using multivariable linear regression adjusted for age and sex. Results: We included 34,509 participants (average age 55 years, 53% female) with no stroke or dementia history. At first and repeat imaging assessments, every 5-point increase in baseline BCS was linked to significantly lower WMH volumes (25% 95% CI [23%-27%] first, 33% [27%-39%] repeat) and higher FA (18% [16%-20%] first, 22% [15%-28%] repeat), with a decrease in MD (9% [7%-11%] first, 10% [4%-16%] repeat). In addition, a higher baseline BCS was associated with a 10% [3%-17%] reduction in WMH progression and FA decline over time. Discussion: This study extends the impact of the BCS to neuroimaging markers of clinically silent cerebrovascular disease. Our results suggest that improving one's BCS could be a valuable intervention to prevent early brain health decline.
UR - https://www.scopus.com/pages/publications/85199875361
U2 - 10.1212/WNL.0000000000209687
DO - 10.1212/WNL.0000000000209687
M3 - Article
AN - SCOPUS:85199875361
SN - 0028-3878
VL - 103
JO - Neurology
JF - Neurology
IS - 4
M1 - e209687
ER -